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General NPI Number Information
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NPI Number | 1821336488
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Entity Type | Individual
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Provider Name | TRACI E NOLIN M.A.,CCC-A
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Gender | Female
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Dates
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Enumeration Date | 01/16/2013
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Last Update Date | 02/28/2020
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Provider Practice Location Address
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Address Line | 2300 N HERRITAGE ST STE C
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City | KINSTON
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State | NC
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Zip | 28501-1652
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Country | US
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Telephone | 252-523-8291
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Fax |
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Provider Business Mailing Address
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Address Line | 254 WATERS EDGE LN
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City | ORIENTAL
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State | NC
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Zip | 28571-8005
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Country | US
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Telephone | 818-469-4815
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | AU1177
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 12508
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License Number State | NC
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